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~ Complete items 1, 2, and 3. Also complete <br />item 4'rf Restricted Delivery is desired. <br />_ :. a Print your name and address on the reverse <br />. ~ ~ ~ ._ so that we can return the card to you. <br />e Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />t. Article Addressed to: <br />RB & Betty Smith <br />455 Webster <br />Burlington CO 80807 <br />A. Signatu ~ - <br />X.~ ~ .~ ^ Agent <br />n'_~Y~cr ~ ^ Atldressee <br />B Rgceived b Pnnted~Name) :. C Date d Delivery <br />~ , ~,~ ~~ ~ <br />~~,ty;/, , ~ ~ ` <br />D` Is de~ery address diffen;M from item 7T ^ Yes , <br />If YES, enter delivery address below: ^ No <br />3. Service Type <br />~{ Certified Mail ^ Express Mail . <br />^ Registered ^ Return Receipt for Merchandise ~~~ <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ y~ <br />2. ArtiuaNUmber 705 116 0003 722 761 <br />(rmnsfer Imm service Labe <br />PS Porrn 3811, February 2004 Domestic Return Receipt iozsss-az-m-tsao ~~- <br />